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Original Articles| Volume 32, ISSUE 6, P518-529.e2, December 2017

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Effect of Preoperative Education on Postoperative Outcomes Among Patients Undergoing Cardiac Surgery: A Systematic Review and Meta-Analysis

      Purpose

      The objective of this review was to assess the effect of preoperative education on postoperative outcomes among patients undergoing cardiac surgery.

      Design

      Systematic review and meta-analysis.

      Methods

      A comprehensive literature search was made on PubMed, CINAHL, Ovid, ProQuest, ScienceDirect, Scopus, Web of Science, and the Cochrane database between 1995 and 2015. Fourteen randomized controlled trials were included. Data analysis was performed with RevMan software and created the Supplementary Appendix using the GRADE approach.

      Findings

      Meta-analysis showed that preoperative education reduced anxiety scores (standardized mean difference = −0.96, 95% confidence interval: −1.37, −0.54; P < .0001). However, there was no significant effect of preoperative education on pain, depression, and length of hospital stay. There is low-quality evidence, and reasons for downgrading are due to study design limitations, inconsistency, and imprecision of effect estimates.

      Conclusions

      The results show that preoperative education can effectively decrease anxiety in patients undergoing cardiac surgery.

      Keywords

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      References

        • Petry J.J.
        Surgery and complementary therapies: A review.
        Altern Ther Health Med. 2000; 6: 64-76
        • Blumenthal J.A.
        • Lett H.S.
        • Babyak M.A.
        • et al.
        Depression as a risk factor for mortality after coronary artery bypass surgery.
        Lancet. 2003; 362: 604-609
        • Albert N.M.
        • Gillinov A.M.
        • Lytle B.W.
        • Feng J.
        • Cwynar R.
        • Blackstone E.H.
        A randomized trial of massage therapy after heart surgery.
        Heart Lung. 2009; 38: 480-490
        • Hemingway H.
        • Marmot M.
        Evidence based cardiology: Psychosocial factors in the aetiology and prognosis of coronary heart disease: Systematic review of prospective cohort studies.
        Br Med J. 1999; 318: 1460-1467
        • Fitzsimons D.
        • Parahoo K.
        • Stringer M.
        Waiting for coronary artery bypass surgery: A qualitative analysis.
        J Adv Nurs. 2000; 32: 1243-1252
        • Andrew M.J.
        • Baker R.
        • Kneebone C.
        • Knight J.L.
        Mood state as a predictor of neuropsychological deficits following cardiac surgery.
        J Psychosom Res. 2000; 48: 537-546
        • Bagheri-Nesami M.
        • Shorofi S.A.
        • Zargar N.
        • Sohrabi M.
        • Gholipour-Baradari A.
        • Khalilian A.
        The effects of foot reflexology massage on anxiety in patients following coronary artery bypass graft surgery: A randomized controlled trial.
        Complement Ther Clin Pract. 2014; 20: 42-47
        • Weis F.
        • Kilger E.
        • Roozendaal B.
        • et al.
        Stress doses of hydrocortisone reduce chronic stress symptoms and improve health-related quality of life in high-risk patients after cardiac surgery: A randomized study.
        J Thorac Cardiovasc Surg. 2006; 131: 277
        • Aslan Ö.
        • Tosun B.
        Cardiovascular surgery patients: Intensive care experiences and associated factors.
        Asian Nurs Res (Korean Soc Nurs Sci). 2015; 9: 336-341
        • Ramesh C.
        • Pai V.B.
        • Patil N.
        • et al.
        Effectiveness of massage therapy on post-operative outcomes among patients undergoing cardiac surgery: A systematic review.
        Int J Nurs Sci. 2015; 2: 304-312
        • Deyirmenjian M.
        • Karam N.
        • Salameh P.
        Preoperative patient education for open-heart patients: A source of anxiety?.
        Patient Educ Couns. 2006; 62: 111-117
      1. Kongstvedt PR, Plocher DW. The Managed Health Care Handbook. {…} Manag Heal Care {…}. 2001. Available at: http://books.google.com/books?hl=en&lr=&id=01RM-eHPxPQC&oi=fnd&pg=PA42&dq=Integrated+health+care+delivery+systems&ots=6glAWxRZnp&sig=7xRHiWug2pGz7FeiFPzezsy-sKU. Accessed July 20, 2016.

        • Kruzik N.
        Benefits of preoperative education for adult elective surgery patients.
        AORN J. 2009; 90: 381-387
        • O'Brien L.
        • Mckeough C.
        • Abbasi R.
        Pre-surgery education for elective cardiac surgery patients: A survey from the patient's perspective.
        Aust Occup Ther J. 2013; 60: 404-409
        • Johnston M.
        • Vögele C.
        Benefits of psychological preparation for surgery: A meta-analysis.
        Ann Behav Med. 1993; 15: 245-256
        • Higgins J.P.T.
        • Green S.
        Cochrane Handbook for Systematic Reviews of Interventions. Vol. 4. John Wiley & Sons, Ltd, West Sussex, England2011 ([Version 5.1.0.])
        • Moher D.
        • Liberati A.
        • Tetzlaff J.
        • Altman D.G.
        Preferred reporting items for systematic reviews and meta-analyses .
        Ann Intern Med. 2014; 151: 264-269
        • Guyatt G.H.
        • Thorlund K.
        • Oxman A.D.
        • et al.
        GRADE guidelines: 13. Preparing Summary of Findings tables and evidence profiles - Continuous outcomes.
        J Clin Epidemiol. 2013; 66: 173-183
        • Arthur H.M.
        • Daniels C.
        • McKelvie R.
        • Hirsh J.
        • Rush B.
        Effect of a preoperative intervention on preoperative and postoperative outcomes in low-risk patients awaiting elective coronary artery bypass graft surgery: A randomized, controlled trial.
        Ann Intern Med. 2000; 133: 253-262
        • Guo P.
        • East L.
        • Arthur A.
        A preoperative education intervention to reduce anxiety and improve recovery among Chinese cardiac patients: A randomized controlled trial.
        Int J Nurs Stud. 2012; 49: 129-137
        • Hoseini S.
        • Soltani F.
        • Babaee Beygi M.
        • Zarifsanaee N.
        The effect of educational audiotape programme on anxiety and depression in patients undergoing coronary artery bypass graft.
        J Clin Nurs. 2013; 22: 1613-1619
        • Kalogianni A.
        • Almpani P.
        • Vastardis L.
        • Baltopoulos G.
        • Charitos C.
        • Brokalaki H.
        Can nurse-led preoperative education reduce anxiety and postoperative complications of patients undergoing cardiac surgery?.
        Eur J Cardiovasc Nurs. 2016; 15: 447-458
        • Martorella G.
        • Cote J.
        • Racine M.
        • Choiniere M.
        Web-based nursing intervention for self-management of pain after cardiac surgery: Pilot randomized controlled trial.
        J Med Internet Res. 2012; 14: 130-145
        • McHugh F.
        • Lindsay G.M.
        • Hanlon P.
        • et al.
        Nurse led shared care for patients on the waiting list for coronary artery bypass surgery: A randomised controlled trial.
        Heart. 2001; 86: 317-323
        • Shahmansouri N.
        • Janghorbani M.
        • Salehi Omran A.
        • et al.
        Effects of a psychoeducation intervention on fear and anxiety about surgery: Randomized trial in patients undergoing coronary artery bypass grafting.
        Psychol Health Med. 2014; 19: 375-383
        • Shuldham C.M.
        • Fleming S.
        • Goodman H.
        The impact of pre-operative education on recovery following coronary artery bypass surgery: A randomized controlled clinical trial.
        Eur Heart J. 2002; 23: 666-674
        • Sorlie T.
        • Busund R.
        • Sexton J.
        • Sexton H.
        • Sorlie D.
        Video information combined with individualized information sessions: Effects upon emotional well-being following coronary artery bypass surgery - A randomized trial.
        Patient Educ Couns. 2007; 65: 180-188
        • Utriyaprasit K.
        • Moore S.M.
        • Chaiseri P.
        Recovery after coronary artery bypass surgery: Effect of an audiotape information programme.
        J Adv Nurs. 2010; 66: 1747-1759
        • Varaei S.
        • Shamsizadeh M.
        • Cheraghi M.A.
        • Talebi M.
        • Dehghani A.
        • Abbasi A.
        Effects of a peer education on cardiac self-efficacy and readmissions in patients undergoing coronary artery bypass graft surgery: A randomized-controlled trial.
        Nurs Crit Care. 2017; 22: 19-28
        • Watt-Watson J.
        • Stevens B.
        • Katz J.
        • Costello J.
        • Reid G.J.
        • David T.
        Impact of preoperative education on pain outcomes after coronary artery bypass graft surgery.
        Pain. 2004; 109: 73-85
        • Zhang C.-Y.
        • Jiang Y.
        • Yin Q.-Y.
        • Chen F.-J.
        • Ma L.-L.
        • Wang L.-X.
        Impact of nurse-initiated preoperative education on postoperative anxiety symptoms and complications after coronary artery bypass grafting.
        J Cardiovasc Nurs. 2012; 27: 84-88
        • Shelley M.
        • Pakenham K.
        The effects of preoperative preparation on postoperative outcomes: The moderating role of control appraisals.
        Heal Psychol. 2007; 26: 183-191
        • Guo P.
        Preoperative education interventions to reduce anxiety and improve recovery among cardiac surgery patients: A review of randomised controlled trials.
        J Clin Nurs. 2015; 24: 34-46
        • Commodore-Mensah Y.
        • Dennison Himmelfarb C.R.
        Patient education strategies for hospitalized cardiovascular patients: A systematic review.
        J Cardiovasc Nurs. 2012; 27 (21p): 154-174

      Biography

      C. Ramesh, MSN, BSN, Manipal College of Nursing, Manipal University, Manipal, Udupi, Karnataka, India

      Biography

      Baby S. Nayak, PhD, MPhil, MSN, BSN, Manipal College of Nursing, Manipal University, Manipal, Udupi, Karnataka, India

      Biography

      Vasudev Baburaya Pai, DNB, MS, MCh, FRCS, Department of Cardiovascular and Thoracic Surgery, Kasturba Medical College & Hospital, Manipal University, Manipal, Udupi, Karnataka, India

      Biography

      Nitin T. Patil, DNB, DA, MBBS, Department of Anaesthesia, Kasturba Medical College & Hospital, Manipal University, Manipal, Udupi, Karnataka, India

      Biography

      Anice George, PhD, MPhil, MSN, BSN, Manipal College of Nursing, Manipal University, Manipal, Udupi, Karnataka, India

      Biography

      Linu Sara George, PhD, MSN, BSN, Department of Fundamentals of Nursing, Manipal College of Nursing, Manipal University, Manipal, Udupi, Karnataka, India

      Biography

      Elsa Sanatombi Devi, PhD, MSN, BSN, Department of Medical Surgical Nursing, Manipal College of Nursing, Manipal University, Manipal, Udupi, Karnataka, India

      Linked Article

      • Erratum
        Journal of PeriAnesthesia NursingVol. 33Issue 5
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          In the original article, “Effect of Preoperative Education on Postoperative Outcomes Among Patients Undergoing Cardiac Surgery: A Systematic Review and Meta-Analysis,” (2017;32:518-529.e2), the first author's name given name should be Ramesh and their surname should be Chandrababu.
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